Q: I’ve recently been diagnosed with borderline personality disorder. However, I’m very confused because while researching this and obtaining as much facts as I can, a primary trait is ‘fear of abandonment’. The reason for the confusion is that for me it’s the opposite. For the past two decades, I’ve abandoned my family (mother, father, siblings), the love of my life, even pets. I’ve COPED with and/or STARTED relationships with an intense passion, with an INITIAL fear of rejection or loss. But after some time passes, something clicks in my brain and I go ‘cold’ and ‘uncaring’. I burn or discard all treasured gifts or mementos and rarely allow myself a ‘memory’.

This hasn’t happened only once — it is a pattern for me. Obviously, this has been very confusing to the people I was lovingly involved with, who were patient and caring with respect to my other mental symptoms, and who I imagine have been extremely hurt and pained by my sudden and permanent departure. Should I question this BPD diagnosis based on the above? Two local medical professionals were uncertain, but a correct diagnosis is very important to me. I have ALL the other symptoms for BPD, except for the abandonment criteria. I’m hoping that you can provide clarification before I embark on rehabilitation (drug therapy, etc.). Thank you for your time, and for this service.

A: In order to meet criteria for this or any diagnosis, you only have to meet a certain number of the criteria — in this case it is 5 out of 9. Even though the fear of abandonment is one of the primary criteria, you could still be diagnosed with BPD without this criterion. However, based on the information you provided, I might venture to guess that you may still have it. Maybe you just bail before anyone can bail on you. This pattern could still be due to an underlying (or unconscious) fear of abandonment.

I hope you will consider therapy in addition to medication. I would personally suggest finding a therapist trained in either Dialectical Behavior Therapy or Eye Movement Desensitization and Reprocessing (EMDR). I hope you can get to the bottom of your issues and begin repairing some of the key relationships in your life. Good luck.